Peripheral vascular disease (PVD) is a slow and progressive circulation disorder. It may involve disease in any of the blood vessels outside of the heart and diseases of the lymph vessels—the arteries, veins, or lymphatic vessels. Organs supplied by these vessels such as the brain, heart, and legs, may not receive adequate blood flow for ordinary function. However, the legs and feet are most commonly affected, thus the name peripheral vascular disease. Conditions associated with PVD that affect the veins include deep vein thrombosis (DVT), varicose veins, and chronic venous insufficiency. Lymphedema is an example of PVD that affects the lymphatic vessels. When PVD occurs in the arteries outside the heart, it may be referred to as peripheral arterial disease (PAD).
There are about 8 million Americans that suffer from PAD. PAD is caused by restriction in arterial flow to the limbs and results in pain when the body can't get needed resources. The largest group of the overall population to get PAD is older, likely diabetic and often with other complicated health issues. The non-amputation surgical solution is often an arterial graft, which has surgical and recovery complications. For this large group a good non-invasive alternative is an Intermittent Pneumatic Compression (IPC) device. An IPC device basically works like a large milking machine, intermittently squeezing on the limb to help circulation. There are several physiologies that occur. The rapidness of the compression simulates muscle contraction like exercise. This creates a chemical response in the limb that tends to develop vascular pathways that ideally can have positive long-term effects. The actual compression tends to empty out the blood in the veins. This reduces venous pressure encouraging arterial blood to empty and return faster. There is also an effect on the lymphatic system as it may enhance draining lymphatic fluid through tissue and nodes to the veins. IPC devices can also enhance wound healing.
The severe condition of PAD is critical limb ischemia (CLI), which affects an estimated 1.1 million Americans and occurs when arterial circulation is so bad it can cause ulcers in the limbs. After 6 months of reaching the CLI stage the mortality rate is 20%. According to The Sage Group, 160,000 PAD related amputations per year are performed in the US. In 60-70% of the CLI amputees, amputation was the first procedure to be performed. Even after surviving the first amputation, the mortality rate is 40% after just 2 years. A second amputation follows 30% of the time with full mobility only being restored 50% of the time. These figures do not consider persons suffering from venous ulcers or lymphedema (swelling) and countries outside the United States, or that the senior citizen population is growing faster than the general population.
IPC devices come in many forms. One type is a small and portable home IPC device that provides limited capacity but is effective on swelling in limited areas, and on less severe CLI cases, provide some wound healing. An example of such a device is the ArtAssist® Device marketed by ACI Medical, LLC of San Marcos, Calif. Another example type is a clinical IPC device which Mayo Clinic uses that costs a great deal more and requires a large amount of space and equipment. This device is the Circulator Boot™ marketed by Circulator Boot Company, LLC, Westerville, Ohio. While perhaps not practical or feasible for home use, this device is somewhat more effective on swelling over larger areas, has greater capacity and longer-term benefit, and can be effective on severe CLI cases encountered in the hospital setting. Both of these types of IPC devices provide only relatively short-term health effects. Once the ulcer is healed, the limb is saved until the next ulcer develops.
Another circulatory condition is Lymphedema. Lymphedema, also known as lymphatic obstruction, is a condition of localized fluid retention and tissue swelling caused by a blockage in the lymphatic system, an important part of the body's immune and circulatory systems. The blockage prevents lymph fluid from draining well, and as the fluid builds up, the swelling continues. Lymphedema is most commonly caused by the removal of or damage to lymph nodes as a part of cancer treatment.